[Anacrusis]

A few days ago during a short flight I had some unusual breathing experiences as the plane started to descend:

• 1 hour of pressing on chest and labored breathing as though breathing reflex went from semi-automatic to manual mode

• Just before landing extreme dizziness and some blacking out feelings for a few seconds at a time

• Sudden shivering from cold when it wasn't cold towards the end

• Got off plane was difficult to put one foot in front of other at first

• Sat in connecting airport a little disorientated for quite a few hours

• On the next flight I took Mestinon and had no problems

This is the third time this has happened but the first times were vague enough for me to dismiss them.

Surely that can't be anything to do with oxygen depletion as 24 hours later I had a brain scan for research and the abundance of firing and wiring and proton activity means that clearly I have quite enough oxygen circulating around my brain! And I did do quite a lot during my trip without too many issues.....I am flying home tomorrow and hope things will go OK...

Anyone had any issues with flying before?

[StephC]

I have been flying two short flights once a month for last 4 months without any of the effects you describe from flight itself.

[alice md]

I am not a flight expert, but the pressure and oxygen level during a flight are different than on the ground.

http://www.who.int/ith/mode_of_travel/cab/en/index.html

This is well tolerated by a healthy person, but can pose a problem to someone with decreased reserves.

I would actually expect increased alertness after such an experience.

[Heat Intolerant]

http://www.ispub.com/journal/the-int....LjKlYbwN.dpbs

I have needed oxygen on flights. I remember one in particular. I would have not have come off the flight had I not received it. Lucky me, I get to rely on the airlines for it. If I ever must fly (I don't unless threatened) and I don't get it, I'll have the rare opportunity to go from immediately from flying to six feet under. (And yes, I have almost blacked out on other flights, gotten off with extreme weakness on others).

I sort of doubt most people on here will be that bad off but I wouldn't guarantee my own survival on a flight with no medical support and even with it, it's a gamble.

[wild_cat]

I haven't flown since having symptoms for one simple reason - I have a very strong gut feeling it would make me extremely unwell. I have never really been able to find an explanation as to why that might be the case but I'm inclined to follow my instincts.

[AnnieB3]

Anacrusis, You were lucky you didn't stop breathing. For people who get such severe symptoms while flying, it's recommended that you have oxygen while on a plane!

I researched this quite awhile ago because I knew I was having trouble while in an airplane. There's also a vignette in my book about it.

It doesn't matter if you felt better after resting awhile or after taking Mestinon. You need to find a pulmonologist and get checked out. There are cardiac conditions that can cause hypoxia or hypoxemia too. There are some people who have pulmonary hypertension and don't even know it. In order to determine if someone has it, a cardiologist will order an echocardiogram.

I have taken an oximeter on airplanes to see for myself what is happening. If I sit in my seat, I'm relatively okay. My O2 hovers around 88%. It can go lower. And my pulse increases, which is the heart trying to get me more oxygen.

When I get up to go to the bathroom on a plane, my O2 goes into the 70's. On one trip, I got a "little" chest pain and was dizzy. I even took photos of the "events" to show my pulmonologist.

The severity has to do with air speed, altitude and pressure. They save money on fuel by manipulating those things. And do you really think they want you to stay hydrated because the cabin air is so dry? Nope, they want you as hydrated as possible so that your veins and arteries will be as dilated as possible so you won't have a heart attack or stroke and screw up their schedule. Or sue them!

Good instincts, wild_cat.

Heat Intolerant, Have you ever had an echocardiogram? You need to figure out why this is happening!

Your brain scan while sitting still on the ground is a lot different than your brain - and other tissues - while up in the air, experiencing low O2!

Annie


http://www.ncbi.nlm.nih.gov/pubmed/12602449

http://www.ncbi.nlm.nih.gov/pubmed/18309903

http://journal.publications.chestnet...icleid=1060686

Isn't it nice of them to think about the pilots?

http://www.avweb.com/news/aeromed/181893-1.html

http://www.hyperbaric-oxygen-info.co...c-hypoxia.html.

[alice md]

Thanks Annie,

I really liked this sentence:

jet aircraft are designed to operate efficiently at high altitudes but the human body is not. Humans are land animals, evolved to exist comfortably close to sea level at a maximum speed (and that for only very short sprints) of little more than 15 miles per hour. Anything else is a foreign, and potentially lethal, environment. Any time we operate above the altitude of acclimatization (the altitude where we normally live), risks exist. No matter how you perceive your performance (and despite all the bravado and tough war stories) the body will still respond to the atmosphere in which it is operating and be affected by gas concentrations and ambient pressures.

MG patients lose their ability to adjust to changes in the environment.

This is a very reasonable explanation one of my respiratory physicians gave me for the fluctuations of MG. He said that even relatively minor changes in barometric pressure, temperature etc. which occur in the atmosphere can lead to decompensation in someone with decreased reserves.

Let alone, the much more extreme changes that occur during a flight.

[Heat Intolerant]

I had an EKG. I don't think it was abnormal but I was referred out for near syncope (in specific circumstances) where I got on the meds I am on. I could barely breathe off the plane when I had the severe respiratory problems. And I expect that earlier on, I just had a high pulse when flying. I would say that the near syncope when that happened was worst standing. And in addition to the oxygen, I "iced" to recover.

[AnnieB3]

An ECG is not sufficient and that's not even my opinion but that of cardiologists. You need an echocardiogram, where they look at the heart, it's size, structures/valves, etc.

Do you have COPD? I just think that anytime someone has such severe breathing issues that they need to be thoroughly evaluated. And why is the answer always, "Here, take this drug!"

I like to use the example of when I had an undiagnosed B12 deficiency. If my doctor had given me Provigil for my fatigue and Neurontin for my parasthesias, I'd be awake and fairly pain free but I'd eventually be dead, since you can't live without B12.

If a cause isn't found, the condition will continue in spite of any treatment. And the treatment isn't always the correct one! Boy, am I grouchy today.

Annie

[Heat Intolerant]

Sorry, yes, they did an echocardiogram and it looked okay.

COPD is progressive. My breathing had improved before meds anyway.

"Here take this drug" is indeed a disaster. I probably would refuse Provigil after similar types of considerations.

Here is some popcorn for your mood: